UNDERNUTRITION 23 



the first impulse is to eat something, much as the baby whose reaction in 

 any ache or pain is to try to relieve it by food. One finds with the layman, 

 the tendency to try first this food, then that, to relieve his symptoms and 

 with even the professional man, the physician himself, a surprising amount 

 of will power is required to fast. The change from a high caloric diet to a 

 diet of fewer calories seen in changing from hard work to a more sedentary 

 life gives one a similar sensation and a feeling of restlessness. Thus, 

 in underfeeding and similarly on changing to a diet with fewer calories, 

 considerable will power is required to restrain from eating more, and if 

 more is not available, anxiety sets in. A man who is being underfed 

 and realizes it will be under considerable mental strain. Thus during the 

 war the irritability of the people from the lower level of feeding was the 

 greatest difficulty that the German government had to meet. 



In absolute fasting the same problem presents itself. Thus, Levanzin 

 was under great mental. strain throughout his fast; it manifested itself 

 by periods of depression and irritability, alternating with periods of en- 

 thusiasm and elation, especially as he realized the fast was nearing an end. 

 ,The hysterical manifestations to the point of mental unbalance after the 

 fast which were brought on by the abdominal discomfort is but an indica- 

 tion of the strain he was under. Doubtless, the f aster's emotions are some- 

 what different from those of the man who changes to a too low diet for the 

 latter doubtless has the hunger pains to remind him of his condition con- 

 tinually and the former does not. 



On return to a normal diet, however, the signs of irritability cease. 

 The undernourished or fasting individual seems to lack initiative. He 

 tends to spare his energies as much as possible. 



Reproductive System. Undernutrition and fasting seem to have a 

 definite effect 'on that other of animal impulses or instincts, that of repro- 

 duction. In animals fasting, one finds that the ovaries and testicles be-' 

 come smaller (Loeb, 1917). The sex impulse and desires, notably in the 

 male, are diminished. This was found in a group of students who had been 

 on a low caloric ration, and the following deductions were drawn. "Any 

 dietetic regime which, even though if affects the external appearance and 

 performance of an individual but little, definitely lowers the tone of the 

 sex instinct, causing one sex to take but little interest in the other, would 

 seem to be disadvantageous to society if indefinitely prolonged and no ad- 

 justments were made in the sex instincts. Our data indicate that nature 

 demands a rather high metabolic level for the normal functioning of sex 

 in man. . . . Riddle and other workers find with animals that sex is 

 closely associated with metabolism and is probably more or less dependent 

 on the metabolic level. These investigators have shown that by.modifying 

 one they may modify the other. It is commonly believed that the sex in- 

 stinct is stronger in men than it is in women. The large amount of 

 metabolism data from this laboratory and other institutions has proved 



